Health
Research insight
INVITED EDITOR
Editorial from
Sara Almeida
PhD Student at Nova SBE | Research Assistant at Global Health & Development Group at Imperial College London
November 16, 2022
3. Good health and well-being

3. Good health and well-being

Ensuring access to quality health and promoting well-being for all, at all ages
LEARN MORE

17. Partnerships for the goals

Strengthen the means of implementation and revitalize the Global Partnership for Sustainable Development
LEARN MORE

Effects of change in hospital treatment payment policy for Palestinian refugees in Lebanon: a health economics analysis

Sara Almeida, Nova SBE PhD student, together with Gloria Paolucci and Seita Akihiro, from the Department of Health, UNRWA, and Hala Ghattas, from the Centre for Research in Population and Health, American University of Beirut, developed this research paper.

BACKGROUND

In 2016, the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) changed from covering the full cost of secondary care in contracted public and private hospitals in Lebanon, Jordan, to requesting that these hospitals pay 10% of the costs. Meanwhile, services at UNWRA-contracted Palestine Red Crescent Society (PRCS) hospitals remained fully covered. We did a health economics analysis to assess the effects this policy change on the demand for secondary care in UNRWA hospitals.

METHODS

We assessed the difference in use of different types of hospital (demand) from January to May, 2016, and June, 2016, to October, 2017, before and after the payment policy change. Data were collected by UNWRA from each hospital's database, including individual-level inpatient information for 22 193 Palestinian refugees in Lebanon who were admitted to secondary care at UNRWA-contracted hospitals (public, private, and PRCS). We used regression analyses to estimate the effects on demand for the different hospital types, length of stay, and total costs of treatment to UNWRA and patients.

FINDINGS

Around 64% of patients attended PRCS, 26% private, and 9% public hospitals. According to our econometric estimations, after June, 2016, patients were 16% more likely to choose a PRCS hospital over the other types of hospital. Mean length of stay in PRCS hospitals increased, leading to a 20% chance of patients staying 1 day longer in PRCS hospitals than in public or private hospitals. However, the length of stay in public and private hospitals decreased (by an average of 22% at public and 28% at private hospitals), giving an overall decrease in length of stay of 13%. In terms of bill value (ie, total costs to UNRWA and to patients), we found no difference between before and after the policy change.

INTERPRETATION

The introduction of the UNWRA cost-sharing component for secondary care led patients to attend PRCS hospitals more often and for longer periods of time. The finding that no effect was seen on costs for UNRWA or patients suggests that the 10% cut in cover at public and private hospitals did not save any money for UNWRA because patients managed to accommodate the increase by changing their hospital preference The study is limited in that it cannot argue causality between the policy and the results found because there is no control group. Nevertheless, robustness testing, including assessing the year 2017, supports our results. This study contributes to the literature on the impacts of co-payments in health care in a very specific context of poverty and conflict that has rarely been subject to scrutiny and provides feedback to UNRWA on a health-care system measure, relevant for future policy designs.

The research paper can be found here

This MSc thesis was supervised by Professor Pedro Pita Barros, Founder of Nova SBE Health Economics & Management Knowledge Center.

Sara Almeida
PhD Student at Nova SBE | Research Assistant at Global Health & Development Group at Imperial College London
LEARN MORE
SHARE

Keep reading

Predicting the Risk of developing Diabetic Nephropathy

Professor Leid Zejnilovic and Bruna Riboldi present the project “Predicting the Risk of developing Diabetic Nephropathy”, winner of the first edition of the Data for Change program and developed in partnership with the Associação Protectora dos Diabéticos de Portugal

Leveraging technology to reach global health: The case of telemedicine in São Tomé and Príncipe health system

Cátia Gonçalves, Ph.D candidate at Nova SBE and researcher at Health Management & Economics Knowledge Center, published recently a research paper on Health Policy and Technology.

Childhood interventions: impacts on health, schooling, and socioeconomic outcomes

The first years of life are crucial for health and well-being throughout life’s course. During our childhood years, we are more malleable and receptive to external influence and this implies that there is an opportunity to promote the development of cognitive, social, and emotional skills.

Over one century of Pharmaceutical Innovation - Incremental Innovation and Strategic repositioning of acetylsalicylic acid (ASA).

Not just only for your common headache! This century old product has an exciting story to tell about reinvention and staying relevant in today’s pharma market.

THE CHOICES OF

Zona de Impacto: Mentalities evolved; however, women are still discriminated in the job market. Why?

Statistics are known. Women have a higher qualification rate than men, but they receive less (for the same jobs) and are more precarious. When it is time to reach roles of responsibility, they have a harder life (and, as the companies get bigger, the worse it is). The topic is old, solutions take a long time to produce effects, and this worries the youth. Marta Everard and Rita Mendes, students at NovaSBE and members of the club Women on Board, explain how they perceive their labor’s future

Subscribe our weekly newsletter

By subscribing to the Nova SBE Role to Play newsletter, you can stay up-to-date on the latest articles posted on the website.
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.

We all have a role to play

We are on a mission to be a community dedicated to the development of talent and knowledge that impacts the world.

With just ten years to go, an ambitious global effort is underway to deliver the 2030 promise. We want to take a stand and we are calling on our community to showcase how they are contributing to the 17 Sustainable Development Goals, whilst influencing more and more people to unravel their role to play.

Here, you will find four different ways your ideas can flourish, dialogue can be enhanced, and action can take place. You can choose one or all four, and Nova SBE will be there to support you all the way and guarantee tangible change.

We all have a role to play, and this is your way in.